ORAL IBOPAMINE SUBSTITUTION IN PATIENTS WITH INTRAVENOUS DOPAMINE DEPENDENCE

In a prospective open study we evaluated whether intravenous dopamine infusions can be safely switched to enterally administered ibopamine i n dopamine-dependent patients. Six patients defined as being clinicall y stable, normovolaemic, but dopamine dependent, i.e. with repeated in ability to stop intravenous dopamine, were included. Ibopamine was adm inistered via a nasogastric or nasoduodenal tube. During the initial 4 8-hour period of ibopamine administration the dopamine infusion was gr adually decreased and then discontinued. Arterial blood pressure was c ontinuously recorded via a 20-gauge cannula in the radial artery. Urin e output was measured each hour. In all 6 patients it was possible to decrease and then discontinue the dopamine infusion whilst maintaining haemodynamic stability and an appropriate diuresis. It was then possi ble to discharge the patients from the intensive care unit. Normovolae mic, clinically stable but dopamine-dependent patients may be weaned o ff intravenous dopamine by substitution of enterally administered ibop amine, allowing discharge from the intensive care unit.